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McKetin R, Degan TJ, Saunders L, Nguyen L, Dore G, Shoptaw S, Farrell M, Degenhardt L, Kelly PJ, Turner A, Clare PJ, Dean OM, Arunogiri S, Colledge-Frisby S, Koeijers J, Goodman-Meza D, Sinclair B, Reid D, Hill H, Hayllar J, Christmass M, Cordaro F, Lundin R, Liaw W, Liu D, Holyoak E, Wu BTF, Keygan J, Kontogiannis A, Palmer L, Morrison C, Wrobel A, Hyland B, Byrne M, Russell S, Zahra E, Berk M. A phase 3 randomised double-blind placebo-controlled trial of mirtazapine as a pharmacotherapy for methamphetamine use disorder: a study protocol for the Tina Trial. Trials 2024; 25:408. [PMID: 38907288 PMCID: PMC11193254 DOI: 10.1186/s13063-024-08238-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND There are no approved pharmacotherapies for methamphetamine use disorder. Two preliminary phase 2 randomised controlled trials have found mirtazapine, a tetracyclic antidepressant, to be effective in reducing methamphetamine use. The proposed Tina Trial is the first phase 3 placebo-controlled randomised trial to examine the effectiveness and safety of mirtazapine as an outpatient pharmacotherapy for methamphetamine use disorder. METHODS This is a multi-site phase 3 randomised, double-blind, placebo-controlled parallel trial. Participants are randomly allocated (1:1) to receive either mirtazapine (30 mg/day for 12 weeks) or matched placebo, delivered as a take-home medication. The target population is 340 people aged 18-65 years who have moderate to severe methamphetamine use disorder. The trial is being conducted through outpatient alcohol and other drug treatment clinics in Australia. The primary outcome is measured as self-reported days of methamphetamine use in the past 4 weeks at week 12. Secondary outcomes are methamphetamine-negative oral fluid samples, depressive symptoms, sleep quality, HIV risk behaviour and quality of life. Other outcomes include safety (adverse events), tolerability, and health service use. Medication adherence is being monitored using MEMS® Smart Caps fitted to medication bottles. DISCUSSION This trial will provide information on the safety and effectiveness of mirtazapine as a pharmacotherapy for methamphetamine use disorder when delivered as an outpatient medication in routine clinical practice. If found to be safe and effective, this trial will support an application for methamphetamine use disorder to be included as a therapeutic indication for the prescription of mirtazapine. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12622000235707. Registered on February 9, 2022.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Tayla J Degan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lucy Saunders
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | | | - Gregory Dore
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, Los Angeles, USA
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Peter J Kelly
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Alyna Turner
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Philip J Clare
- Prevention Research Collaboration, The University of Sydney, Sydney, Australia
| | - Olivia M Dean
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Shalini Arunogiri
- Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University, Melbourne, Australia
| | - Samantha Colledge-Frisby
- Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Juanita Koeijers
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - David Goodman-Meza
- Center for HIV Identification, Prevention, and Treatment Services, Los Angeles, USA
| | - Barbara Sinclair
- Illawarra Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, NSW Health, Wollongong, Australia
| | - David Reid
- Illawarra Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, NSW Health, Wollongong, Australia
| | - Harry Hill
- Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Jeremy Hayllar
- Biala City Community Health Centre, Metro North Health, Brisbane, Australia
| | - Michael Christmass
- Next Step Community Alcohol and Drug Service East Perth, East Perth, Australia
| | - Frank Cordaro
- Illawarra Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, NSW Health, Wollongong, Australia
| | - Robert Lundin
- Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Willy Liaw
- Drug and Alcohol Services of South Australia, Adelaide, Australia
| | - Danica Liu
- Drug and Alcohol Services of South Australia, Adelaide, Australia
| | - Ellie Holyoak
- Alcohol, Tobacco & Other Drug Services, Townsville, Australia
| | | | - Joel Keygan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Ava Kontogiannis
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Lily Palmer
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Caity Morrison
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Anna Wrobel
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Bec Hyland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Marianne Byrne
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Samantha Russell
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
- Grampians Health, Ballarat, Australia
| | - Emma Zahra
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Michael Berk
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
- Drug and Alcohol Services, Barwon Health, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
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Ezard N, Clifford B, Dunlop A, Bruno R, Carr A, Liu Z, Siefried KJ, Lintzeris N. Safety and tolerability of oral lisdexamfetamine in adults with methamphetamine dependence: a phase-2 dose-escalation study. BMJ Open 2021; 11:e044696. [PMID: 34006547 PMCID: PMC8137170 DOI: 10.1136/bmjopen-2020-044696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To examine the safety of an agonist-type treatment, lisdexamfetamine (LDX), at 250 mg/day among adults with methamphetamine (MA) dependence. DESIGN A dose-escalating, phase-2, open-label, single-group study of oral LDX at two Australian drug treatment services. SETTING The study was conducted at two Australian stimulant use disorder treatment clinics. PARTICIPANTS There were 16 participants: at least 18 years old, MA dependent for at least the preceding 2 years using ICD-10 criteria, reporting use of MA on at least 14 of the preceding 28 days. INTERVENTIONS Daily, supervised LDX of 100-250 mg, single-blinded to dose, ascending-descending regimen over 8 weeks (100-250 mg over 4 weeks; followed by 4-week dose reduction regimen, 250-100 mg). Participants were followed through to week 12. OUTCOMES Primary outcomes were safety, drug tolerability and regimen completion at the end of week 4. Participants were followed to week 12. Secondary outcomes included: change in MA use; craving; withdrawal; severity of dependence; risk behaviour; change in other substance use; medication acceptability; potential for non-prescription use; adherence and neurocognitive functioning. RESULTS Fourteen of 16 participants (87.5%) completed escalation to 250 mg/day. Two participants withdrew from the trial in the first week: one relocated away from the study site, the other self-withdrew due to a possible, known side effect of LDX (agitation). There was one serious adverse event of suicidal ideation which resolved. All other adverse events were mild or moderate in severity and known side effects of LDX. No participant was withdrawn due to adverse events. MA use decreased from a median of 21 days (IQR: 16-23) to 13 days (IQR: 11-17) over the 4-week escalation period (p=0.013). CONCLUSIONS LDX at a dose of up to 250 mg/day was safe and well tolerated by study participants, warranting larger trials as a pharmacotherapy for MA dependence. TRIAL REGISTRATION NUMBER ACTRN12615000391572.
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Affiliation(s)
- Nadine Ezard
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- National Centre for Clinical Research on Emerging Drugs, C/O University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- National Drug and Alcohol Research Centre, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- Drug and Alcohol Clinical Research and Improvement Network, C/O South East Sydney Local Health District, Sydney, New South Wales, Australia
| | - Brendan Clifford
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- Susan Wakil School of Nursing & Midwifery, The University of Sydney, Sydney, New South Wales, Australia
| | - Adrian Dunlop
- Drug and Alcohol Clinical Research and Improvement Network, C/O South East Sydney Local Health District, Sydney, New South Wales, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle Faculty of Health, Callaghan, New South Wales, Australia
| | - Raimondo Bruno
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Andrew Carr
- Centre for Applied Medical Research, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
| | - Zhixin Liu
- Centre for Applied Medical Research, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- Mark Wainwright Analytical Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Krista J Siefried
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- National Centre for Clinical Research on Emerging Drugs, C/O University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- National Drug and Alcohol Research Centre, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Nicholas Lintzeris
- Drug and Alcohol Clinical Research and Improvement Network, C/O South East Sydney Local Health District, Sydney, New South Wales, Australia
- Division of Addiction Medicine, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- The Langton Centre, South East Sydney Local Health District, Sydney, New South Wales, Australia
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Yan C, Yang X, Yang R, Yang W, Luo J, Tang F, Huang S, Liu J. Treatment Response Prediction and Individualized Identification of Short-Term Abstinence Methamphetamine Dependence Using Brain Graph Metrics. Front Psychiatry 2021; 12:583950. [PMID: 33746790 PMCID: PMC7965948 DOI: 10.3389/fpsyt.2021.583950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/01/2021] [Indexed: 01/21/2023] Open
Abstract
Background: The abuse of methamphetamine (MA) worldwide has gained international attention as the most rapidly growing illicit drug problem. The classification and treatment response prediction of MA addicts are thereby paramount, in order for effective treatments to be more targeted to individuals. However, there has been limited progress. Methods: In the present study, 43 MA-dependent participants and 38 age- and gender-matched healthy controls were enrolled, and their resting-state functional magnetic resonance imaging data were collected. MA-dependent participants who showed 50% reduction in craving were defined as responders to treatment. The present study used the machine learning method, which is a support vector machine (SVM), to detect the most relevant features for discriminating and predicting the treatment response for MA-dependent participants based on the features extracted from the functional graph metrics. Results: A classifier was able to differentiate MA-dependent subjects from normal controls, with a cross-validated prediction accuracy, sensitivity, and specificity of 73.2% [95% confidence interval (CI) = 71.23-74.17%), 66.05% (95% CI = 63.06-69.04%), and 80.35% (95% CI = 77.77-82.93%), respectively, at the individual level. The most accurate combination of classifier features included the nodal efficiency in the right middle temporal gyrus and the community index in the left precentral gyrus and cuneus. Between these two, the community index in the left precentral gyrus had the highest importance. In addition, the classification performance of the other classifier used to predict the treatment response of MA-dependent subjects had an accuracy, sensitivity, and specificity of 71.2% (95% CI = 69.28-73.12%), 86.75% (95% CI = 84.48-88.92%), and 55.65% (95% CI = 52.61-58.79%), respectively, at the individual level. Furthermore, the most accurate combination of classifier features included the nodal clustering coefficient in the right orbital part of the superior frontal gyrus, the nodal local efficiency in the right orbital part of the superior frontal gyrus, and the right triangular part of the inferior frontal gyrus and right temporal pole of middle temporal gyrus. Among these, the nodal local efficiency in the right temporal pole of the middle temporal gyrus had the highest feature importance. Conclusion: The present study identified the most relevant features of MA addiction and treatment based on SVMs and the features extracted from the graph metrics and provided possible biomarkers to differentiate and predict the treatment response for MA-dependent patients. The brain regions involved in the best combinations should be given close attention during the treatment of MA.
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Affiliation(s)
- Cui Yan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Xuefei Yang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Ru Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenhan Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jing Luo
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Fei Tang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Sihong Huang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
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Palis H, Guh D, MacDonald S, Harrison S, Brissette S, Marsh DC, Schechter MT, Oviedo-Joekes E. Longitudinal patterns of cocaine use among patients receiving injectable hydromorphone or diacetylmorphine for the treatment of opioid use disorder: A growth curve modeling approach. Drug Alcohol Depend 2021; 218:108333. [PMID: 33268225 DOI: 10.1016/j.drugalcdep.2020.108333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Cocaine use is prevalent among people receiving injectable opioid agonist treatment. Investigations of cocaine use in this population have been descriptive and the potential heterogeneity existing in patterns of use have not been characterized. As such, among patients receiving injectable opioid agonist treatment, this study aimed to: 1) quantify intra- and inter-individual variation in cocaine use over 24-months and; 2) determine how predictors of interest explained this variation. METHODS Participants were patients receiving injectable opioid agonist treatment for opioid use disorder. Study visits were completed at baseline prior to receiving treatment, and 3,6,9,12,18, and 24 months after baseline. A multi-level regression approach to growth curve modeling was employed to estimate and explain intra- (within-person) and inter-individual (between-person) variation in cocaine use. RESULTS Significant intra and inter-individual variation in cocaine use was identified over 24-months. Treatment engagement was on average associated with reductions in the prior month number of days of cocaine use (range: 0-30)(Estimate (standard error): -0.05(0.02), p = 0.003). On average, men reported less cocaine use compared to women (Estimate (standard error): -5.91(1.57), p=<0.001), and participants reporting ever regularly using cocaine at baseline reported more cocaine use over 24-months compared to participants reporting never regularly using cocaine (Estimate (standard error): 4.72 (1.91), p = 0.013). CONCLUSIONS Significant reductions in cocaine use were observed and significant heterogeneity in patterns of cocaine use was identified. These heterogeneous cocaine use profiles suggest that an individualized approach to care will be critical in responding to patients' cocaine use in injectable opioid agonist treatment.
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Affiliation(s)
- Heather Palis
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Daphne Guh
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Scott MacDonald
- Providence Health Care, Providence Crosstown Clinic, 84 West Hastings Street, Vancouver, BC, V6B 1G6, Canada
| | - Scott Harrison
- Providence Health Care, Providence Crosstown Clinic, 84 West Hastings Street, Vancouver, BC, V6B 1G6, Canada
| | - Suzanne Brissette
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis, Montréal, QC, H2X 0A9, Canada
| | - David C Marsh
- Northern Ontario School of Medicine, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada; Canadian Addiction Treatment Centres, 175 Commerce Valley West, Suite 300, Markham, Ontario, L3T 7P6, Canada; ICES North, 41 Ramsey Lake Rd, Sudbury, ON, P3E 5J1, Canada; Health Sciences North Research Institute, 56 Walford Rd, Sudbury, ON, P3E 2H2, Canada
| | - Martin T Schechter
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Eugenia Oviedo-Joekes
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
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Ezard N, Dunlop A, Hall M, Ali R, McKetin R, Bruno R, Phung N, Carr A, White J, Clifford B, Liu Z, Shanahan M, Dolan K, Baker AL, Lintzeris N. LiMA: a study protocol for a randomised, double-blind, placebo controlled trial of lisdexamfetamine for the treatment of methamphetamine dependence. BMJ Open 2018; 8:e020723. [PMID: 30030312 PMCID: PMC6059315 DOI: 10.1136/bmjopen-2017-020723] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Methamphetamine dependence is a growing public health concern. There is currently no pharmacotherapy approved for methamphetamine dependence. Lisdexamfetamine (LDX) dimesylate, used in the treatment of attention-deficit hyperactivity disorder and binge eating disorder, has potential as an agonist therapy for methamphetamine dependence, and possible benefits of reduced risk of aberrant use due to its novel formulation. METHODS AND ANALYSIS A double-blind randomised controlled trial will be used to evaluate the efficacy of LDX in reducing methamphetamine use. The target sample is 180 participants with methamphetamine dependence of ≥2 years, using ≥14 days out of the previous 28, who have previously attempted but not responded to treatment for methamphetamine use. Participants will be randomly assigned to receive either a 15-week intervention consisting of induction (1 week of 150 mg LDX or placebo), maintenance (12 weeks of 250 mg LDX or placebo) and reduction (1 week of 150 mg LDX or placebo and 1 week of 50 mg LDX or placebo). All participants will be given access to four sessions of cognitive-behavioural therapy as treatment as usual and receive a 4-week follow-up appointment. The primary outcomes are efficacy (change from baseline in days of methamphetamine use by self-report for the last 28 days at week 13 and urinalyses confirmation of methamphetamine use) and safety (treatment-related adverse events). Secondary outcomes are total number of days of self-report methamphetamine use over the 12-week active treatment, longest period of abstinence during treatment period, percentage of achieving ≥21 days abstinence, craving, withdrawal, dependence, retention, bloodborne virus transmission risk behaviour, criminal behaviour, as well measures of abuse liability, physical and mental health, other substance use, cognitive performance, psychosocial functioning, treatment retention and satisfaction. Additionally, the study will assess the cost-effectiveness of LDX relative to the placebo control. ETHICS AND DISSEMINATION The study has been approved by the Human Research Ethics Committee of St. Vincent's Hospital, Sydney, Australia (HREC/16/SVH/222). Contact the corresponding author for the full trial protocol. TRIAL REGISTRATION NUMBER ACTRN12617000657325; Pre-results.
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Affiliation(s)
- Nadine Ezard
- Alcohol and Drug Service, St Vincents Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Randwick, New South Wales, Australia
| | - Adrian Dunlop
- Drug and Alcohol Clinical Services, Hunter New England, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Michelle Hall
- Drug and Alcohol Clinical Services, Hunter New England, Newcastle, New South Wales, Australia
| | - Robert Ali
- University of New South Wales, Randwick, New South Wales, Australia
- University of Adelaide, Adelaide, South Australia, Australia
| | | | - Raimondo Bruno
- University of South Australia, Adelaide, South Australia, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Nghi Phung
- Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Andrew Carr
- Alcohol and Drug Service, St Vincents Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Randwick, New South Wales, Australia
| | - Jason White
- University of South Australia, Adelaide, South Australia, Australia
| | - Brendan Clifford
- Alcohol and Drug Service, St Vincents Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Zhixin Liu
- University of New South Wales, Randwick, New South Wales, Australia
| | - Marian Shanahan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kate Dolan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicholas Lintzeris
- University of Sydney, Sydney, New South Wales, Australia
- South East Sydney Local Health District, Sydney, New South Wales, Australia
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Morley KC, Cornish JL, Faingold A, Wood K, Haber PS. Pharmacotherapeutic agents in the treatment of methamphetamine dependence. Expert Opin Investig Drugs 2017; 26:563-578. [PMID: 28351169 DOI: 10.1080/13543784.2017.1313229] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Methamphetamine use is a serious public health concern in many countries and is second to cannabis as the most widely abused illicit drug in the world. Effective management for methamphetamine dependence remains elusive and the large majority of methamphetamine users relapse following treatment. Areas covered: Progression in the understanding of the pharmacological basis of methamphetamine use has provided us with innovative opportunities to develop agents to treat dependence. The current review summarizes relevant literature on the neurobiological and clinical correlates associated with methamphetamine use. We then outline agents that have been explored for potential treatments in preclinical studies, human laboratory phase I and phase II trials over the last ten years. Expert opinion: No agent has demonstrated a broad and strong effect in achieving MA abstinence in Phase II trials. Agents with novel therapeutic targets appear promising. Advancement in MA treatment, including translation into practice, faces several clinical challenges.
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Affiliation(s)
- Kirsten C Morley
- a NHMRC Centre for Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine , The University of Sydney , Sydney , Australia
| | - Jennifer L Cornish
- b Department of Psychology , Centre for Emotional Health, Macquarie University , Sydney , Australia
| | - Alon Faingold
- c Drug Health Services , Royal Prince Alfred Hospital , Camperdown , Australia
| | - Katie Wood
- a NHMRC Centre for Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine , The University of Sydney , Sydney , Australia
| | - Paul S Haber
- a NHMRC Centre for Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine , The University of Sydney , Sydney , Australia.,c Drug Health Services , Royal Prince Alfred Hospital , Camperdown , Australia
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